Clinical Judgment

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Question 1

Free

Multiple Choice

A student nurse is studying clinical judgment theories and is working with Tanner's Model of Clinical Judgment. How can the student nurse best generalize this model?

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A reflective process where the nurse notices, interprets, responds, and reflects in action

One conceptual mechanism for critiquing ideas and establishing goal-oriented care

Researching best practice literature to create care pathways for certain populations

Assessing, diagnosing, implementing, and evaluating the nursing care plans

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Question 2

Free

Multiple Choice

The nurse is implementing a plan of care for a patient newly diagnosed with type 2 diabetes mellitus. The plan includes educating the patient about diet choices. The patient states that they enjoy exercising and understand the need to diet; however, they can't see living without chocolate on a daily basis. Using the principles of responding in the Model of Clinical Judgment, how would the nurse proceed with the teaching?

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The nurse explains to the patient that chocolate has a high glycemic index. The nurse then focuses on foods that have low glycemic indexes and provides a list for the patient to choose from.

The nurse explains that the patient may eat whatever they would like as long as the patient's glucose reading and A1c remain stable.

The nurse derives a new nursing diagnosis of Knowledge Deficit and readjusts the plan of care to include additional sessions with the registered dietician.

The nurse examines the patient's daily glucose log and incorporates the snack into the time of day that has the lowest readings. The nurse then follows up and evaluates the response in 1 week.

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Question 3

Free

Multiple Choice

A new graduate nurse is working with an experienced nurse to chart assessment findings. The new nurse notes that the physical therapist wrote on the chart that the patient is lazy and did not want to participate in assigned therapies this AM. The experienced nurse asks the new nurse what may be going on here. What is the best explanation for this statement?

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Data on the chart can sometimes be documented in a biased manner.

Data on the chart changes as the patient's condition changes.

Data on the chart is usually accurate and can be verified from the patient.

Reading the chart is not a wise use of time as this can be time consuming and tedious.

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Question 4

Free

Multiple Choice

A home care nurse receives a physician order for a medication that the patient does not want to take because the patient has a history of side effects from this medication. The nurse carefully listens to the patient, considers it in light of the patient's condition, questions its appropriateness, and examines alternative treatments. What is the nurse's best action?

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Call the physician, explain rationale, and suggest a different medication.

Consult an experienced nurse on whether there are other similar treatments.

Hold the drug until the physician returns to the unit and can be questioned.

Question other staff as to the physician's acceptance of nursing input.

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Question 5

Free

Multiple Choice

A patient has been admitted for a skin graft following third degree burns to the bilateral calves. The plan of care involves 3 days inpatient and 6 months outpatient treatment, to include home care and dressing changes. When should the nurse initiate the educational plan?

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After the operation and the patient is awake

On admission, along with the initial assessment

The day before the patient is to be discharged

When narcotics are no longer needed routinely

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Question 6

Multiple Choice

A nurse has designed an individualized nursing care plan for a patient, but the patient is not meeting goals. Further assessment reveals that the patient is not following through on many items. Which action by the nurse would be best for determining the cause of the problem?

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Assess whether the actions were too hard for the patient.

Determine whether the patient agrees with the care plan.

Question the patient's reasons for not following through.

Reevaluate data to ensure the diagnoses are sound.

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Question 7

Multiple Choice

A new nurse appears to be second-guessing herself and is constantly calling on the other nurses to double-check their plan of care or rehearse what they will say to the doctor before she call on the patient's behalf. This seems to be annoying some of the nurse's coworkers. What is the nurse manager's best response?

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Explain to coworkers that this is a characteristic of critical thinking and is important for the new nurse to improve reasoning skills.

Agree with the staff and have someone follow and work more closely with a preceptor.

Have a talk with the nurse and suggest asking fewer questions.

Tell the staff that all new nurses go through this phase, and ignore their behavior.

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Question 8

Multiple Choice

A nurse has committed a serious medication error and has reported the error to the hospital's adverse medication error hotline as well as to the unit manager. The manager is a firm believer in developing critical thinking skills. From this standpoint, what action by the manager would best nurture this ability in the nurse who made the error?

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Have the nurse present an in-service related to the cause of the error.

Instruct the nurse to write a paper on how to avoid this type of error.

Let the nurse work with more experienced nurses when giving medications.

Send the nurse to refresher courses on medication administration.

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Question 9

Multiple Choice

A nurse is caring for a patient in a long-term care facility who has not been sleeping well. She notes that the patient is new to the facility, has been refusing therapy, and is also not eating well. The nurse interprets this to mean that the patient has been having trouble adjusting. The nurse decides to meet with the patient's care team. The team decides to assess the patient's willingness to participate in group recreational activities, The patient agrees to participate. After 1 week, the nurse reevaluates the plan of care and notes that the patient has been sleeping much better. Which of the following terms best describe processes used in the nurse's plan? (Select all that apply.)

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Clinical judgment

Evidence-based practice

The nursing process

Collaborative care planning

Positive reward process

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